ABSTRACT
Migraine is the most common headache disorder with high prevalence. Clinical features which forms basis for diagnosis are heterogenous, varying from person to person and in an individual patient from one headache to the next. In most of the migraineurs treatment is delayed, until the disease severity is high leading to significant disability and socioeconomic burden. Many patients receive various combination of prolonged therapy with no significant benefits. Identifying a biomarker for migraine might help in assessing the susceptibility, diagnosing the disease early, choosing appropriate therapeutic target and monitoring the disease course. Here in this review authors discuss most studied, promising biomarkers emerging in field of migraine. The keywords migraine, and biomarkers were used in the search engines of PubMed and Google scholar and articles identified were extensively reviewed. Genetic biomarkers ascertain susceptibility or predisposition to migraine and are valuable in diagnosis, developing novel therapeutic agents, assessing treatment response. This review briefs about most studied genetic and circulatory biomarkers of migraine. Further research into existing biomarkers with higher sample size, excluding confounding factors is necessary. Search for newer biomarkers which can be of great value in diagnosis and therapy is needed. Identifying a biomarker which is reliable, replicable, easily available and cost-effective is need of the hour in management of migraine.
ABSTRACT
Introduction: Blunt abdominal trauma occurs when injuryto organs inside abdominal cavity is present due to externalforces exerted over abdomen as result of trauma. Widespectrum of clinical presentation is seen ranging from milderforms of injury to fatal solid organ injuries with irreversibleshock and ongoing bleeding. Management ranges fromwatchful observation to emergency laparotomy. Aim ofthis study was to evaluate different clinical presentation,organ specific injury and management of blunt abdominaltrauma.Material and Methods: A retrospective study with 25patients sustaining Blunt abdominal trauma who came toTrauma centre in Guru Gobindsingh Government Hospital,Jamnagar attached to medical college from 2016 to 2018 wereincluded. The patients were selected randomly.Results: Blunt abdominal injury was seen in all age from 1 to60 years. Highest incidence noted in age group 11 to 20 years.Male predominance was noted with Male: Female ratio21:4 of5.25:1.Most common mode of injury was road traffic accident(44%). Most common injured organ was Liver (32%).Liver and spleen injuries were associated with rib fractures.Abdominal pain and tenderness was most common clinicalpresentation (90%). Patients with hemodynamic instabilityhad more mortality.Conclusion: Blunt abdominal injury is one of the commonestinjuries encountered in polytrauma patients. Morbidity andmortality can be prevented by timely initial resuscitation andcorrect diagnosis as well as management (operative or nonoperative) which depend on patient’s hemodynamic stabilityand findings of imaging studies.